H-Behaviours - 2018

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Zappelphilipp

Zappelphilipp (or Fidgety Philip) is considered to be the godfather of ADHD. The cartoons on the right show him expressing disruptive behaviours that can be interpreted in various ways, the most common of which is ADHD. In Summer School 2017, a mixed group of young university students investigated how their observations were altered by subjective interpretations. Analysis of the Zappelphilipp cartoons was the first step towards the goal of developing a shared, neutral annotation language.

A neutral annotation language would focus on describing the main characteristics of challenging or disruptive H-Behaviours without subjective interpretations. In this manner, people of different backgrounds can more easily reach consensus in diagnoses and develop a shared understanding.

We learned that (1) qualitative information had to be divided into (i) descriptions; and (ii) interpretations and (2) descriptions, interpretations, and predictions are formed by the “Gestalt”-perception of each individual. (3) A reduction of interpretations can be reached with advancing learning experience. However, pictograms can catalyze this process and may serve as the neutral language we were looking for.

Project Leads: Osman Ipsiroglu & Gerhard Klösch

Project Partners: Members of the H-Behaviours Group at BCCHR, Christine A. Loock, Suzanne Lewis, Gabriella Horvath, Alexander Rauscher, Sylvia Stockler; Members of the Vienna Research Hub, Georg Dorffner, Heinrich Garn, Bernhard Kohn; & Members of the Video Working Group of the International Pediatric Sleep Association: Hans-Jürgen Kühle (Giessen), Barbara Schneider (Landshut), Rosalia Silvestri (Messina); Karen Spruyt (Lyon), Arthur Walters (Nashville)

Research Assistants: Nadia Beyzaei; Emmanuel Tse; Hebah Hussaina; Seraph Bao; Khaola Safia Maher & Summer Students 2017: Mackenzie Campbell; Natasha Carson; Jecika Jeyaratnam

Publications: Abstracts, Posters, Book Articles, Peer Reviewed Articles, Reports

Funding: BBD – Catalyst Grant 2017, BC Children’s Hospital Research Institute; Summer Student Scholarships 2017, BC Children’s Hospital Research Institute

Acknowledgements: Struwwelpeter Museum Frankfurt (Frankfurt, Germany); Medical University of Vienna & Institute for Sleep-Wake Research Vienna, Austria

 
 
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SCIT/SIT

The SCIT (Suggested Clinical Immobilization Test) standardizes observations of movements (e.g. ‘the-urge-to-move’ and ‘movement-soothing’ behaviours) and postures related to H-Behaviours during daytime. It can be applied by professionals in their office and by parents at home. In the office, the formal SCIT is administered to both the patient and accompanying caregivers (parent(s), sibling(s)) and is based on collaboratively (re)viewing the ‘sitting behaviours’ on a height-wise appropriate chair together. In cases where the formal SCIT cannot be administered (e.g., due to lack of comprehension, behavioural compliance or motor ability), the person of interest is observed in an ‘informal’ SCIT while moving around, coming to a rest position, and at the initiation of movements (see lower figure). Discussing the observations captured during the formal and/or informal SCIT with the caregivers prompts additional narratives about similar situations at home.

The SCIT lasts for a maximum of five minutes, facilitates naturalistic observations and an explorative discussion on experienced sensations. It is the further development of the SIT (Suggested Immobilization Test), a 45 minute lasting, sleep lab based, structured test of leg movement recordings during the montage of the lids for the sleep study. The top right figure demonstrates the SCIT, while the bottom right figure demonstrates the SIT.

A child who is considered to display disruptive behaviour in a classroom setting may be considered as having ADHD or on the Autism Spectrum by some professionals, or simply RLS by others (Dr. Ipsiroglu Thesis). There is frequent disagreement among descriptive diagnoses, given the different sub-specialization of the assessing professionals. Therefore, our research at the H-Behaviour Research Lab aims to reduce the impact of differing training backgrounds on clinical diagnoses by standardizing behavioural descriptions and creating an international shared ‘annotation language’.

(1) With the research conducted since 2016 at the RREACH- & H-Behaviour Labs, we have created the foundational data for behavioural classification of H-Behaviours in health young adults. (2) A pictogram based Pattern Analysis Mind Map was developed. (3) A customized interface utilizing the pictograms was integrated into the Annotator Software for Windows 10 (Copyrighted by the Austrian Institute of Technology & H-Behaviours Lab, BC Children’s Hospital Research Institute). (4) For analysis of movement patterns, participants were recorded with standard 2-D and novel 3-D-video systems, with integrated EMG recordings of leg movements and the Sleep Smart Mattress.

Project Leads: Osman Ipsiroglu (2013-Present) & HF Machiel Van der Loos (2016-Present) & Leonid Sigal (2018-Present) & Gerhard Klösch (2016-Present)

Project Partners: Members of the H-Behaviours Group at BCCHR, Christine A. Loock, Suzanne Lewis, Gabriella Horvath, Alexander Rauscher, Sylvia Stockler; Members of the Vienna Research Hub, Georg Dorffner, Heinrich Garn, Bernhard Kohn; & Members of the Video Working Group of the International Pediatric Sleep Association: Catherine Hill (Southampton), Sue McCabe (Perth), Hans-Jürgen Kühle (Giessen), Barbara Schneider (Landshut), Rosalia Silvestri (Messina); Karen Spruyt (Lyon), Arthur Walters (Nashville)

Research Assistants: Nadia Beyzaei (2014-18); Emmanuel Tse (2016-18), Yi Jui Lee (2016-18); Mai Berger (2013-17); Alexandra Wagner (2014-15); Duncan Wong (2013-14); Hebah Hussaina (2017-18); Seraph Bao (2017-18), Khaola Safia Maher (2017-18), Mai Berger (2013-17); Summer Students in 2017: Mackenzie Campbell, Natasha Carson, Jecika Jeyaratnam

Publications: Abstracts, Posters, Book Articles, Peer Reviewed Articles, Reports

Funding: BBD – Catalyst Grant, BC Children’s Hospital Research Institute (2017); BC Children’s Hospital Foundation & Children’s Sleep Network (2013- ); Kids Brain Health Network (previously NeuroDevNet 2014/15); Treatable Intellectual Disability Endeavour, BC Children’s Hospital Research Institute (previously Child Family Research Institute, 2013-2015)

Acknowledgements: Medical University of Vienna & Institute for Sleep-Wake Research Vienna, Austria; Austrian Institute of Technology, Vienna, Austria.